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To evaluate the variations in COVID-19 case fatality rates (CFRs) across different regions and waves, and the impact of public health interventions, social and economic characteristics, and demographic factors on COVID-19 CFRs, we collected data from 30 countries with the highest incidence rate in three waves. We summarized the CFRs of different countries and continents in each wave through meta-analysis. Spearman’s correlation and multiple linear regression were employed to estimate the correlation between influencing factors and reduction rates of CFRs. Significant differences in CFRs were observed among different regions during the three waves (P < 0.001). An association was found between the changes in fully vaccinated rates (rs = 0.41), population density (rs = 0.43), the proportion of individuals over 65 years old (rs = 0.43), and the reduction rates of case fatality rate. Compared to Wave 1, the reduction rates in Wave 2 were associated with population density (β = 0.19, 95%CI: 0.05–0.33) and smoking rates (β = −4.66, 95%CI: −8.98 – −0.33), while in Wave 3 it was associated with booster vaccine rates (β = 0.60, 95%CI: 0.11–1.09) and hospital beds per thousand people (β = 4.15, 95%CI: 1.41–6.89). These findings suggest that the COVID-19 CFRs varied across different countries and waves, and promoting booster vaccinations, increasing hospital bed capacity, and implementing tobacco control measures can help reduce CFRs.
The Wood Snipe Gallinago nemoricola is one of the least known shorebird species, and its habitat associations are very poorly understood. Here we provide the first assessment of the habitat use of the Wood Snipe during the breeding season. Between May and July 2021 at a 4-km2 alpine meadow in Sichuan province, China, we conducted population surveys and behavioural observations to identify sites where breeding Wood Snipe occurred and foraged. We quantified the habitat characteristics and food resource availability of these sites and compared them with randomly selected “background” sites. Comparison between 34 occurrence sites and 25 background sites indicated that during the breeding season, Wood Snipes are not distributed evenly across alpine meadow habitats, but preferred habitats in the lower part (3,378–3,624 m) of the alpine meadow with intermediate levels of soil moisture. In addition, comparison between 17 foraging sites and 24 background sites showed that the Wood Snipe tended to forage at sites with higher soil fauna abundance. We found weak evidence for denser vegetation cover at its height and no evidence for other biotic habitat variables such as vegetation composition or other abiotic habitat variables such as slope, soil penetrability, or disturbance level to influence Wood Snipe habitat associations. Our results suggest that the actual distribution range of the Wood Snipe during the breeding season may be smaller than expected from the extent of apparently suitable habitat. We advise caution in evaluating the potential habitat availability and distribution of the Wood Snipe, and call for further research to better understand the ecology of this rare species to inform its conservation.
We provide an umbrella review of the reported polysomnographic changes in patients with neuropsychiatric diseases compared with healthy controls.
Methods
An electronic literature search was conducted in EMBASE, MEDLINE, All EBM databases, CINAHL, and PsycINFO. Meta-analyses of case–control studies investigating the polysomnographic changes in patients with neuropsychiatric diseases were included. For each meta-analysis, we estimated the summary effect size using random effects models, the 95% confidence interval, and the 95% prediction interval. We also estimated between-study heterogeneity, evidence of excess significance bias, and evidence of small-study effects. The levels of evidence of polysomnographic changes in neuropsychiatric diseases were ranked as follows: not significant, weak, suggestive, highly suggestive, or convincing.
Results
We identified 27 articles, including 465 case–control studies in 27 neuropsychiatric diseases. The levels of evidence of polysomnographic changes in neuropsychiatric diseases were highly suggestive for increased sleep latency and decreased sleep efficiency (SE) in major depressive disorder (MDD), increased N1 percentage, and decreased N2 percentage, SL and REML in narcolepsy, and decreased rapid eye movement (REM) sleep percentage in Parkinson's disease (PD). The suggestive evidence decreased REM latency in MDD, decreased total sleep time and SE in PD, and decreased SE in posttraumatic stress disorder and in narcolepsy.
Conclusions
The credibility of evidence for sleep characteristics in 27 neuropsychiatric diseases varied across polysomnographic variables and diseases. When considering the patterns of altered PSG variables, no two diseases had the same pattern of alterations, suggesting that specific sleep profiles might be important dimensions for defining distinct neuropsychiatric disorders.
Two new genera and six new species of trilobites are systematically documented herein: Sinagnostus mirabilis new genus new species, Yanpingia punctata n. gen. n. sp., Illaenus taoyuanensis n. sp., Panderia striolatus n. sp., Nileus yichongqiaoensis n. sp., and Paratiresias peculiaris n. sp. The materials were collected from the Darriwilian (late Middle Ordovician) strata in the Upper Yangtze Region, South China. Also provided is an emended diagnosis of the genus Paratiresias based on the new species Paratiresias peculiaris, which is the oldest known species of this genus with an extremely narrow (sag. and exsag.) preglabellar field. Those Chinese species previously referred to Nanillaenus are reassigned to Illaenus sensu lato. These trilobites add new data for the Darriwilian trilobite macroevolution and show highly endemic to South China and the faunal exchanges between South China and Tarim, Kazakhstan, Alborz, as well as Sibumasu and North China.
Nutritional Risk Screening index is a standard tool to assess nutritional risk, but epidemiological data are scarce on controlling nutritional status (CONUT) as a prognostic marker in acute haemorrhagic stroke (AHS). We aimed to explore whether the CONUT may predict a 3-month functional outcome in AHS. In total, 349 Chinese patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. The cohort patients were divided into high-CONUT (≥ 2) and low-CONUT (< 2) groups, and primary outcomes were a poor functional prognosis defined as the modified Rankin Scale (mRS) score of ≥ 3 at post-discharge for 3 months. Odds ratios (OR) with 95 % confidence intervals (CI) for the poor functional prognosis at post-discharge were estimated by using a logistic analysis with additional adjustments for unbalanced variables between the high-CONUT and low-CONUT groups. A total of 328 patients (60·38 ± 12·83 years; 66·77 % male) completed the mRS assessment at post-discharge for 3 months, with 172 patients at malnutrition risk at admission and 104 patients with a poor prognosis. The levels of total cholesterol and total lymphocyte counts were significantly lower in high-CONUT patients than low-CONUT patients (P = 0·012 and < 0·001, respectively). At 3-month post discharge, there was a greater risk for the poor outcome in the high-CONUT compared with the low-CONUT patients at admission (OR: 2·32, 95 % CI: 1·28, 4·17). High-CONUT scores independently predict a 3-month poor prognosis in AHS, which helps to identify those who need additional nutritional managements.
Composite materials include various components with different structures, which cooperatively increase their properties and extend their application. In this study, the graphitic carbon nitride (g-C3N4) guest material was assembled into the porous of the SiO2 aerogel, which was prepared during the gel process. By this way, the g-C3N4 could be absolutely encapsulated into the porous of the disordered porous SiO2 aerogel. The prepared g-C3N4/SiO2 composite had a loose porous structure and exhibited the much higher photocatalytic activity to the photodegradation of rhodamine B (RhB) under visible light. The disordered porous structure enhanced photocatalytic activity, and the degradation rate reached to 96.42% in 90 min under the irradiation of visible light, which could be attributed to its high surface area and effective electron–hole separation rate. The catalyst had the much higher stability and could be easily recycled utilization. The prepared composites could be applied to degrade organic pollutants in wastewater.
Process parameters (laser power and scanning speed) for H13 steel specimens produced by selective laser melting (SLM) are optimized, and microstructural characteristics and mechanical properties are investigated. The optimum process parameters are a laser power of 170 W and a scanning speed of 400 mm/s according to the maximum relative density of 99.2%. The microstructure consists of cellular grains and columnar crystal, which are composed of lath martensite and retained austenite, and there are no carbides or other second-phase particles present. The size of cellular grains is 1 μm. Compared with the common processed (forged and heat-treated) H13, SLM H13 has similar microhardness (561 HV) and tensile strength (1909 MPa) values. However, the elongation (12.4%) is a factor of ∼3 times higher and the impact energy (14.4 J) of the SLM specimen is somewhat lower. The relationship between the microstructure and mechanical properties is discussed. Fine grains and no second-phase precipitation determine the strength and plasticity of SLM samples.
In high power laser facility for inertial confinement fusion research, final optics assembly (FOA) plays a critical role in the frequency conversion, beam focusing, color separation, beam sampling and debris shielding. The design and performance of FOA in SG-II Upgrade laser facility are mainly introduced here. Due to the limited space and short focal length, a coaxial aspheric wedged focus lens is designed and applied in the FOA configuration. Then the ghost image analysis, the focus characteristic analysis, the B integral control design and the optomechanical design are carried out in the FOA design phase. In order to ensure the FOA performance, two key technologies are developed including measurement and adjustment technique of the wedged focus lens and the stray light management technique based on ground glass. Experimental results show that the design specifications including laser fluence, frequency conversion efficiency and perforation efficiency of the focus spot have been achieved, which meet the requirements of physical experiments well.
The Shen-Guang II Upgrade (SG-II-U) laser facility consists of eight high-power nanosecond laser beams and one short-pulse picosecond petawatt laser. It is designed for the study of inertial confinement fusion (ICF), especially for conducting fast ignition (FI) research in China and other basic science experiments. To perform FI successfully with hohlraum targets containing a golden cone, the long-pulse beam and cylindrical hohlraum as well as the short-pulse beam and cone target alignment must satisfy tight specifications (30 and $20~\unicode[STIX]{x03BC}\text{m}$ rms for each case). To explore new ICF ignition targets with six laser entrance holes (LEHs), a rotation sensor was adapted to meet the requirements of a three-dimensional target and correct beam alignment. In this paper, the strategy for aligning the nanosecond beam based on target alignment sensor (TAS) is introduced and improved to meet requirements of the picosecond lasers and the new six LEHs hohlraum targets in the SG-II-U facility. The expected performance of the alignment system is presented, and the alignment error is also discussed.
Babesiosis is an emerging tick-transmitted zoonosis prevalent in large parts of the world. This study was designed to determine the rates of Babesia microti infection among small rodents in Yunnan province, where human cases of babesiosis have been reported. Currently, distribution of Babesia in its endemic regions is largely unknown. In this study, we cataloged 1672 small wild rodents, comprising 4 orders, from nine areas in western Yunnan province between 2009 and 2011. Babesia microti DNA was detected by polymerase chain reaction in 4·3% (72/1672) of the rodents analyzed. The most frequently infected rodent species included Apodemus chevrieri and Niviventer fulvescens. Rodents from forests and shrublands had significantly higher Babesia infection rates. Genetic comparisons revealed that Babesia was most similar to the Kobe- and Otsu-type strains identified in Japan. A variety of rodent species might be involved in the enzootic maintenance and transmission of B. microti, supporting the need for further serological investigations in humans.
Restudy of two Early Silurian (Aeronian) stricklandioid species, Stricklandinia transversa Grabau, 1925 and Stricklandiella robusta Rong and Yang, 1981 from the Yichang area of South China, leads to the recognition of two new genera, Sinokulumbella and Sinostricklandiella. Two types of spondylia and four types of cardinalia are recognized for the Stricklandioidea and can be used for classification of the superfamily at the generic or even familial level. On the basis of these characters, five groups (typified by Stricklandia, Stricklandiella, Kulumbella, Microcardinalia, and Aenigmastrophia) can be recognized within the superfamily. Sinokulumbella n. gen., with a small, shallow, bowl-shaped spondylium and a pair of outer hinge plates that are discrete from the crura, is regarded to be affiliated with the Kulumbella group. Sinostricklandiella n. gen. has superimposed plicae and costae, although its internal structures are similar to the Stricklandiella group. A revised classification of stricklandioids implies that the Chinese pentamerides were characterized by strong provincialism during the early and middle Llandovery. This interpretation is supported further by the complete lack of true Stricklandia and Microcardinalia lineages in South China. Different stocks of stricklandioids in Baltica, Laurentia, South China, Siberia, and Kazakhstan may have experienced allopatric evolution, punctuated by several pulses of faunal migration or exchange between these paleoplates during the Llandovery. Evolution of the Stricklandia lineage is significantly different from that of Kulumbella and Sinokulumbella, particularly in that the outer plates disappeared earlier in the kulumbellids than in the stricklandiids.
Reexamination of type and topotype material revealed the presence of well-developed ventral and dorsal interareas in two virgianid brachiopods from South China, Eoconchidium jiangshanensis Liang (in Liu et al., 1983) and Paraconchidium shiqianensis Rong, Xu, and Yang, 1974, of Late Ordovician and Early Silurian ages, respectively. A cladistic analysis of the common virgianid taxa, incorporating new data on the development of interareas, confirms Paraconchidium Rong, Xu, and Yang, 1974 as a valid genus (not a junior synonym of Pseudoconchidium Nikiforova and Sapelnikov, 1971) and warrants E. jiangshanensis as the type species of Deloprosopus new genus (not allied to either Eoconchidium or Tcherskidium as previously believed). Our preliminary survey on the suborder Pentameridina, based on available material or illustrations of well-preserved, disarticulated (typically silicified) valves, indicates that 1) the interareas are more commonly developed in the superfamily Pentameroidea than was reported previously, especially in the families Virgianidae and Subrianidae; 2) the ventral and dorsal interareas commonly do not occur as paired planar surfaces in the Pentameroidea, as they do in the superfamily Stricklandioidea; and 3) despite the common absence of a ventral interarea, the development of a sharply delimited dorsal interarea appears to be ubiquitous in the Pentameroidea and possibly in the suborder Pentameridina. In the currently adopted classification, the presence of matching ventral and dorsal interareas is treated as one of the diagnostic characters that separate Stricklandioidea from other superfamilies of the Pentameridina. The new data presented herein on the development of interareas imply the need to reevaluate the taxonomic and evolutionary significance of the ventral and dorsal interareas, pending a thorough survey on their distribution in the suborder Pentameridina.
Microstructural and property evolution of 1050 commercial pure aluminum subjected to high-strain-rate deformation (1.2–2.3 × 103 s−1) by split Hopkinson pressure bar (SHPB) and subsequent annealing treatment were investigated. The as-deformed and their annealed samples at 373–523 K were characterized by transmission electron microscopy (TEM) and microhardness tests. TEM observations reveal that the as-deformed sample is mainly composed of a lamellar structure, whose transverse/longitudinal average subgrain/cell sizes are 293 and 694 nm, respectively. The initial coarse grains are refined significantly. The initial lamellar grain structures are subdivided into pancake-shaped subgrains due to a gradual transition by triple junction motion at 473 K, and then a dramatic microstructural coarsening is observed at 523 K. It is suggested that annealing behavior of this dynamic loading structure is better considered as a continuous process of grain coarsening or continuous recovery.
The NASA Kepler satellite has provided unprecedented high duty-cycle, high-precision light curves for a large number of stars by continuously monitoring a field of view in Cygnus-Lyra region, leading to great progress in both discovering exoplanets and characterizing planet-hosting stars by means of asteroseismic methods. The asteroseismic survey allows the investigation of stars covering the whole H-R diagram. However, the low precision of effective temperatures and surface gravities in the KIC catalogue and the lack of information on chemical composition, metallicity and rotation rate prevent asteroseismic modeling, requiring spectroscopic observations for thousands of asteroseismic targets in the Kepler field in a homogeneous way.
Eospirifer praecursor n. sp. is the oldest known eospiriferine, probably ancestral to the entire Spirifer group. It is described here based on external and internal mold material from the uppermost part of the Changwu Formation (mid-Ashgill, Late Ordovician), Hejiashan, Jiangshan, western Zhejiang, East China. A study of the ontogeny of E. praecursor n. sp. suggests that the cardinalia of early growth stages are more similar to those of early atrypoids rather than to those of the orthoids but the brachidia in these earliest Eospirifer are still unknown. The possibility that eospiriferines were derived from an atrypoid stock cannot be excluded. All early eospiriferine species recorded from the Ashgill, Rhuddanian, and early Aeronian are reviewed for comparison. Their morphological diversification reveals early evolutionary experimentation. Based on the Ashgill occurrence of Eospirifer, it is likely that East Asia may be considered as one of the eospiriferine source areas.
Holorhynchus giganteus Kiaer, 1902, a common Late Ordovician (mid-Ashgill) pentameride brachiopod in the Baltic region, Kazakhstan, and southern Tien Shan, is documented for the first time from the Badanjilin Formation (mid-Ashgill) of western Inner Mongolia (Alxa block), North China. Serial sections of the Chinese material confirm the presence of a vestigial ventral median septum in the early growth stage of H. giganteus, but the septum becomes embedded in the secondary shell thickening at the adult growth stage. A survey of the type material from Norway and additional material from other regions indicates that the incipient ventral median septum is a much more commonly developed structure than was previously believed. The presence of a well-developed pseudodeltidium in the Tien Shan material of H. giganteus and the absence of such a structure in conspecific material from many other regions require a systematic revision of the generic group. Holorhynchus has rodlike crura (=brachial processes) that do not form flanges at their junctions with the inner hinge plates (=outer plates = crural plates) and outer hinge plates (inner plates). This, together with the development of a crude spondylial comb structure, points to its affinity to the Virgianidae rather than to the Stricklandiidae. Holorhynchus can be regarded as a Lazarus taxon because of its absence during the crisis (Hirnantian) and survival (early-middle Rhuddanian) intervals associated with the Late Ordovician mass extinction and its reappearance in Kazakhstan and North China during the Early Silurian (late Rhuddanian-early Aeronian). The mid-Ashgill Holorhynchus fauna, typified by a number of large-shelled pentamerides, was common in the Baltic region, the Urals, Kazakhstan, Tien Shan, Alxa, Qaidam, Kolyma, and east-central Alaska, but largely absent from Laurentia and Siberia (except for Taimyr) in the ancient tropical-subtropical regions. This paleobiogeographic pattern agrees with the general pattern of the Late Ordovician brachiopod provincialism.
Ca0.98Eu0.02Al1−4δ/3Si1+δN3 (δ = 0–0.36) red-emitting phosphors were prepared by carbothermal reduction and nitridation method with stable and inexpensive CaCO3 as Ca source. Optimal nominal composition was obtained at δ = 0.18, showing intense emission peaked at 625 nm and high external quantum efficiency of 71%. The emission wave length could be successfully tuned from 630 to 606 nm with increasing δ value. Ca0.98Eu0.02Al1−4δ/3Si1+δN3 phosphors provided two coordinated environments for Eu2+ ions, resulting in two fitted Gaussian peaks. Energy transfer from Eu2+ sites in Si-rich environments to those in Si/Al-equivalent modes has been confirmed by analysis of the decay curve of each peak. The decay behaviors suggested that energy transfer effect slowed with higher δ value. Finally, warm white light was created by combining as-prepared red-emitting Ca0.98Eu0.02Al0.76Si1.18N3 and yellow-emitting YAG:Ce3+ phosphors with a blue-emitting chip, exhibiting a color rendering index Ra of 91 at a low correlated color temperature of 3500 K with a luminous efficiency of 79 lm/W.
To investigate the impact of 1-week ventilator circuit change on ventilator-associated pneumonia and its cost-effectiveness compared with a 2-day change.
Design
An observational cohort study.
Setting
A tertiary level neonatal intensive care unit in a university-affiliated teaching hospital in Taiwan.
Patients
All neonates in the neonatal intensive care unit receiving invasive intubation for more than 1 week from July 1, 2011, through December 31, 2013.
Intervention
We investigated the impact of 2 ventilator circuit change regimens, either every 2 days or 7 days, on ventilator-associated pneumonia of our cohort.
Measurements and Main Results
A total of 361 patients were maintained on mechanical ventilators for 13,981 days. The 2 groups did not differ significantly in any demographic characteristics. The rate of ventilator-associated pneumonia was comparable between the 2-day group and the 7-day group (8.2 vs 9.5 per 1,000 ventilator-days, P=.439). The durations of mechanical ventilation and hospital stay, and rates of bloodstream infection and mortality, were also comparable between the 2 groups. Switching from a 2-day to a 7-day change policy would save our neonatal intensive care unit a yearly sum of US $29,350 and 525 working hours.
Conclusion
Decreasing the frequency of ventilator circuit changes from every 2 days to once per week is safe and cost-effective in neonates requiring prolonged intubation for more than 1 week.